Indigestion

Question 1

What are the symptoms of indigestion (8)

Answer 1

1. Acid
2. Heartburn
3. Gas
4. Bloating
5. Wind
6. Dyspepsia
7. Burning
8. Upset stomach

Question 2

What is indigestion (4)

Answer 2

1. also known as dyspepsia,
2. can present as a burning pain, a heaviness or an ache.
3. Normally, the stomach produces the right amount of acid to aid with the digestion of food.
4. Sometimes, too much of this acid is produced and the acid irritates the stomach lining or the oesophagus, causing the painful, burning sensation.

Question 3

What is heartburn (3)

Answer 3

1. There is a type of valve called a sphincter which is made of muscle. This usually stays closed to keep food in the stomach.
2. If this valve become weak for some reason then food and stomach acid can come up from the stomach into the tube that leads to the stomach from the mouth (oesophagus). This is called reflux.
3. The oesophagus does not have the protective lining the stomach has so the acid can cause irritation and a burning pain felt high in the chest. This pain is known as heartburn.

Question 4

What are the causes of indigestion and heartburn (8)

Answer 4

1. Eating or drinking too much in one sitting
2. Spicy or fatty foods
3. Pregnancy
4. Medications (e.g. NSAIDs)
5. Excessive alcohol
6. Smocking
7. Overweight
8. Stress

Question 5

What questions should you ask for indigestion (7)

Answer 5

1. WWHAM
2. Where is the pain located
3. The type of pain/discomfort
4. Whether the pain is worse or better after eating
5. Whether the pain is severe
6. If the pain is spreading to other parts of the body
7. If the pain is relieved by indigestion remedies

Question 6

Who should you refer to the pharmacist for indigestion (12)

Answer 6

1. Anyone who is 55 years of age or older and is suffering from indigestion/heartburn symptoms for the first time
2. If your customer says that the pain has been spreading to other parts of their body, or that it is severe
3. People who tell you that they have had or are having treatment for a stomach ulcer
4. People who have been vomiting and/or have any unexplained weight loss
5. People who are already taking any other medications
6. Children
7. Elderly people
8. Pregnant or breastfeeding women
9. People who have not had any relief with the indigestion remedies they have already tried or that the pain is getting worse.
10. Anyone vomiting blood or blood-stained vomit that may look like coffee grounds
11. Anyone passing dark, blood-stained bowel movements that may look black and tarry
12. People who have difficulty swallowing

Question 7

What treatments are there for indigestion and heartburn (4)

Answer 7

1. Alginates
2. Antacids
3. H2-receptor antagonists
4. Proton-pump inhibitors

Question 8

What are alginates (3)

Answer 8

1. work by forming a barrier sometimes called a raft, over the stomach contents that reduces any reflux into the oesophagus.
2. Alginates should be taken after food and before bed for longer lasting effect.
3. e.g. Alginic acidandsodium alginate

Question 9

What are antacids (5)

Answer 9

1. work by neutralising the acid in the stomach which reduces the symptoms.
2. Antacids can provide fast relief for mild to moderate symptoms of indigestion.
3. Magnesium and aluminium are often used together because magnesium causes diarrhoea and aluminium causes constipation, so they counteract each other’s side effects.
4. Sodium bicarbonate is a very fast acting antacid but the effects are short-lived. It combines with the acid in the stomach and produces carbon dioxide gas, making people burp. People with high blood pressure and those on a low sodium diet, and should avoid this.
5. Calcium carbonate can cause constipation and should not be used long term, as it can cause other more serious side effects.

Question 10

What are H2-receptor antagonists (5)

Answer 10

1. stop the production of stomach acid by blocking one of the ways acid is formed in the stomach.
2. Currently there are no H2-receptor antagonists for sale over-the-counter.
3. Famotidine is prescription-only, and another H2-receptor antagonist.
4. They should not be taken by anyone under 16 years, or used continuously for more than two weeks at a time without a prescription from the doctor
5. On prescription, H2 receptor antagonists can also be used to prevent and treat stomach ulcers. However, this must be decided by a doctor and on prescription only

Question 11

What are side effects of H2-receptor antagonists (7)

Answer 11

1. diarrhoea
2. headaches
3. stomach upsets
4. dizziness
5. skin rash
6. tiredness.
7. If the patient experiences any of these side effects, you should refer them to the pharmacist to see if they should continue taking this medication.

Question 12

What are proton-pump inhibitors (4)

Answer 12

1. stop production of acid in the stomach by blocking an enzyme called the hydrogen potassium ATPase, found in the cells of the stomach wall.
2. When bought over the counter, they should only be used for short term treatment.
3. e.g. Omeprazole,esomeprazoleandpantoprazole
4. PPIs are also used to treat and prevent stomach ulcers on prescription. However, PPIs should never be sold over the counter for stomach ulcer

Question 13

What are common side effects of PPIs (7)

Answer 13

1. nausea
2. vomiting
3. abdominal pain
4. flatulence
5. diarrhoea
6. constipation
7. headaches.